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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: DEPUY ORTHOPAEDICS INC US ALTRX +4 10D 32IDX50OD; PINNACLE HIP SYSTEM : HIP POLY ACETABULAR LINERS

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DEPUY ORTHOPAEDICS INC US ALTRX +4 10D 32IDX50OD; PINNACLE HIP SYSTEM : HIP POLY ACETABULAR LINERS Back to Search Results
Model Number 1221-32-150
Device Problems Difficult to Insert (1316); Defective Device (2588)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 02/15/2023
Event Type  malfunction  
Manufacturer Narrative
Product complaint # (b)(4).Depuy synthes is submitting this report pursuant to the provisions of 21 cfr, part 803.This report may be based on information which depuy synthes has not been able to investigate or verify prior to the required reporting date.This report does not reflect a conclusion by fda, depuy synthes or its employees that the report constitutes an admission that the device, depuy synthes, or its employees caused or contributed to the potential event described in this report.If information is obtained that was not available for the initial medwatch, a follow-up medwatch will be filed as appropriate.
 
Event Description
It was reported that while revising this patient¿s hip for dislocation, it was determined by trialing that patient would need a +4 10 degree liner.The appropriate liner was opened, a pinnacle altrx +4 10 degree 32mm x 50mm to match her cup size.The surgeon had a clean and clear view with no obstructions when placed the liner into the cup with the lip positioned posteriorly where surgeon wanted it.When surgeon impacted the liner, the posterior ard¿s would not seat.Surgeon took the liner out and made sure again nothing was blocking the liner from being able to seat, impacted it and same thing.They opened a different liner of the same size, positioned it appropriately, impacted it and it went right in.The surgeon considered that there was something wrong with the ard¿s in the first liner as it was very odd that it would not seat.The anterior ard¿s had seated fine.There was no surgical delay.
 
Manufacturer Narrative
Product complaint # (b)(4).Investigation summary: no device associated with this report was received for examination.The information received will be retained for potential series investigations if triggered by trend analysis, post market surveillance, or other events within the quality system.Depuy considers the investigation closed.Should additional information be received, the information will be reviewed and the investigation will be re-opened as necessary.Device history lot: a manufacturing record evaluation (nc search) was performed for the finished device 122132150, lot m0120u, and no non-conformances / manufacturing irregularities were identified.
 
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Brand Name
ALTRX +4 10D 32IDX50OD
Type of Device
PINNACLE HIP SYSTEM : HIP POLY ACETABULAR LINERS
Manufacturer (Section D)
DEPUY ORTHOPAEDICS INC US
700 orthopaedic drive
warsaw IN 46581 0988
Manufacturer (Section G)
DEPUY ORTHOPAEDICS, INC. 1818910
700 orthopaedic dr.
warsaw IN 46581 0988
Manufacturer Contact
kate karberg
700 orthpaedic dr.
warsaw, IN 46581
3035526892
MDR Report Key16455406
MDR Text Key310379528
Report Number1818910-2023-04706
Device Sequence Number1
Product Code LPH
UDI-Device Identifier10603295016168
UDI-Public10603295016168
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K072963
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Health Professional,Company Representative
Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date 02/28/2023
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received02/28/2023
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Model Number1221-32-150
Device Catalogue Number122132150
Device Lot NumberM0120U
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Date Manufacturer Received03/16/2023
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured06/28/2022
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
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